Individual provider Active NPI

Frederick Stanley Wreford III, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Overland Park, KS
National Provider Identifier
1942289673
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
04-41791 Issued in KS
Practice address
7301 College Blvd Ste 110
Overland Park, KS 66210
Phone
(913) 341-6297
Fax
(913) 341-6299
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 04-41791 KS Primary

Addresses

Primary practice location

7301 College Blvd Ste 110
Overland Park, KS 66210

Mailing address

7301 College Blvd Ste 110
Overland Park, KS 66210-1856
Phone (913) 341-6297

Other identifiers 1

IdentifierTypeStateIssuer
22-0-73-0373-1OtherMIBCBS PIN OR CPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190819000286 MO Practitioner - Pathology 7113025149 Reassigns benefits to 2 organizations
I20231006002119 IL Practitioner - Pathology 7113025149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

6800 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-5711

Hospital & facility affiliations

  • Anderson Hospital Hospital, Maryville, IL, CCN 140289
  • Community Hospital of Staunton Hospital, Staunton, IL, CCN 141306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-41791KSMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Sep 1, 2023 Accepting new patients
SSM Health Care Group Anatomic Pathology & Clinical Pathology CurrentSince Sep 1, 2023 Accepting new patients
Advance Pathology Services P.C. Past Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1942289673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 COLLEGE BLVD STE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101856",
            "telephone_number": "913-341-6297",
            "fax_number": "913-341-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 COLLEGE BLVD STE 110",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-341-6297",
            "fax_number": "913-341-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREFORD",
        "first_name": "FREDERICK",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "04-41791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN OR CPC",
            "identifier": "22-0-73-0373-1",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.